大脑岛叶及其毗邻结构的解剖

目的:观察岛叶及其毗邻的重要结构,为岛叶区域的手术提供一些相关的解剖数据.方法:对10例(20侧)成人尸头标本进行岛叶,外侧裂和大脑中动脉等结构的解剖与测量.结果:岛叶大体上呈1个三角形区域,表面由4～7个岛回组成,周围以前、上和下环岛沟为界与额、顶、颞叶分隔开.岛叶与外侧裂、岛盖、大脑中动脉、侧脑室、基底节和内囊关系密切.结论:对于岛叶及其毗邻解剖结构关系的理解,有助于岛叶区肿瘤的切除、基底节血肿的清除和颅内动脉瘤的治疗,减少术后并发症的发生具有重要意义.     

经外侧裂入路行基底节区高血压脑出血手术的解剖和技巧

目的:为经外侧裂行基底节区高血压手术提供显微外科解剖学基础和手术技巧。方法:15例头颅湿标本,模拟手术入路观察外侧裂区解剖结构和相互毗邻关系并进行手术入路研究。结果:视辐射分前、中、后3束,前束覆盖颞角前尖端顶壁和侧壁,中束在颞角上壁和侧壁,前束和后束从外侧膝状体发出后向前卷曲,而后束离开外侧膝状体后终止于距状沟上岸没有向前的卷曲,后束走行于侧脑室下角的外侧壁,这样视辐射纤维存在于脑侧面的颞角的顶壁和中后及侧壁,颞角下壁没有视辐射纤维;经外侧裂、梨状皮质和钩的入路行基底节区高血压手术时,可以不损伤视辐射和钩束。结论:手术入路经外侧裂通过钩前面和上面的梨状皮质能安全进入基底节区而不损伤视辐射和钩束的主要部分。     

经外侧裂-岛叶切除岛叶胶质瘤手术入路的显微解剖学研究

目的 通过尸头标本模拟经外侧裂-岛叶入路的相关解剖结构,为临床医师进行岛叶胶质瘤手术提供参考,从而在提高肿瘤全切率的同时能最大程度保护脑组织功能。方法 在10例尸头标本上进行外侧裂、岛叶、大脑中动脉区域的解剖研究,拍照并观察各重要结构的关系及测量相关参数。结果 岛中央沟与大脑表面的中央沟相齐平,将岛叶分为前半部分和后半部分,前半部分为3～5个岛短回,后半部分由2个岛长回构成。岛叶前半部分被额下回三角部、盖部和中央前回覆盖;岛叶后半部分的上方被中央后回、缘上回覆盖,下方被赫氏勒回覆盖。岛叶被上纵束环绕,上纵束联系额颞顶枕叶,钩束在岛叶下方连接额叶和颞叶。经侧裂暴露到达上界沟区域、前岛点,额眶部至少需要牵拉2.0 cm,牵拉时要避免对Broca区的损伤。暴露岛叶下界沟则需要牵拉颞叶2.5 cm,牵拉压迫过程中应注意避免损伤颞横回。结论 经外侧颞-岛叶入路可充分暴露岛叶,适合切除纯岛叶胶质瘤。对于其他类型岛叶胶质瘤,前岛点和前界沟位置容易暴露,后岛点及下界沟暴露更为困难。     

股骨前外侧入路应用解剖

目的:为股骨前外侧手术入路提供解剖学资料。方法:60侧成人尸体标本上,按股骨前外侧手术入路对股外侧肌神经和旋股外侧动脉降支的走行和毗邻关系进行了观察。结果:股外侧肌神经恰位于股骨前外侧入路切口的深面,横跨股骨干,与旋股外侧动静脉的降支伴行,在距髂前上棘(149.6±105.4)mm、耻骨结节(136.8±113.2)mm处分支进入股外侧肌。结论:行股骨前外侧入路显露股骨上1/3时,用缝线标志或用橡皮筋牵拉股外侧肌神经及其伴行的旋股外侧动静脉降支至一侧予以保护。     

肱骨前外侧手术入路与解剖

目的:为肱骨前外侧手术入路时避免损伤桡神经提供解剖学资料。方法:在42侧成人尸上肢标本上,根据手术进路和易损伤部位对桡神经和旋肱前动脉的行径及毗邻关系进行了观测。结果:桡神经进入桡神经管上口位于胸大肌腱止端内侧2.3±0.24cm,喙突下方10.73±0.45cm。旋肱前血管经胸大肌腱上缘上方0.66±0.03cm处横过。结论:沿胸大肌腱止端处纵行切开骨膜并将其连同胸大肌腱一同翻向内侧,可避免损伤桡神经近段(管上段);沿骨膜下向远侧分离,可避免损伤桡神经中段(管内段);沿肱肌中线分开肱肌至骨膜下,可避免损伤桡神经远段(管下段)。     

颅骨骨缝与大脑表面关系的解剖学研究

目的研究颅骨骨缝与大脑表面的解剖位置关系,为开颅手术等提供更加精确的定位。方法对6具尸体的头颅标本(12侧)进行解剖观察,并记录数据和留取图像资料。结果外侧裂位于鳞状缝的下方,与外侧裂线不重叠,外侧裂线平均高于外侧裂。左侧中央沟位于上、下中央沟点连线上,右侧中央沟的中段与上、下中央沟点连线基本重叠,上、下两端稍偏向连线之后,冠状缝与中央沟的距离上宽下窄。结论了解颅骨骨缝与大脑表面的解剖位置关系对神经外科开颅手术中从正确的颅骨骨瓣成形至快速地到达颅内特定部位有一定帮助。     

椎动脉寰椎部的应用解剖

目的:研究椎动脉寰椎部的解剖,为临床应用提供解剖学依据.方法:成人尸头标本,解剖观察椎动脉寰椎部的形态结构,测量椎动脉寰椎部及其毗邻结构.结果:椎动脉寰椎部可分为寰枕段及寰枢椎段2部分;椎动脉寰椎部有恒定而连续的4个血管襻;周围有丰富的椎旁静脉丛,第2颈椎神经前根恒定地紧贴于椎动脉寰椎部寰枕段背侧.结论:对椎动脉寰椎部的解剖及其毗邻结构的研究,对于远外侧手术入路中避免椎动脉的损伤有重大临床意义.     

髋关节前外侧入路的应用解剖及临床意义

目的 :为髋关节前外侧入路及易损伤结构提供解剖学依据。方法 :对 6 0侧成尸下肢标本 ,参照手术进路的层次对相关结构和神经血管进行解剖观测。结果 :(1)股外侧皮神经干 80 %斜跨切口线下部 ;第一分支阔筋膜浅层穿出点位于髂前上棘下方 (6 .2± 2 .5 )cm ,主干阔筋膜深层穿出点位于髂前上棘下方 (1.6± 1.2 )cm ,此段主干位于阔筋膜浅深两层之间 ,周围充满脂肪组织。 (2 )股直肌直头呈圆柱形 ,其前内侧是股三角 ,后外侧是髋关节囊 ,仅遮挡髋关节囊前内侧 1 6部分。 (3)股神经股外侧肌支从前内上行向下外斜跨切口延长线 ,分数支入股外侧肌 ,其最上支与切口延长线交点位于髂前上棘下方 (12 .4± 2 .6 )cm ,结论 :(1)此入路浅层分离时应先在髂前上棘下 5 .0cm以内的阔筋膜浅深两层之间脂肪组织中寻找并保护股外侧皮神经 ,然后再分离切口下部浅筋膜。 (2 )在深层分离时应沿股直肌直头外侧深入至髋关节囊 ,切匆误入其前内侧的股三角。股直肌直头如果没有挛缩 ,可不必切断 ,以便患者尽早进行功能锻炼。 (3)切口如需向下延长时 ,不宜超过髂前上棘下 9.0cm ;如果必须再延长应向外侧偏斜 ,以免伤及股神经股外侧肌支。     

髋前外侧肌间隙入路治疗股骨转子间骨折的应用解剖

目的    为髋前外侧肌间隙手术入路治疗股骨转子间骨折提供解剖学基础。  方法    12侧成人尸体下肢标本,模拟髋前外侧肌间隙入路对相关结构和神经血管进行解剖观测。  结果    臀中肌阔筋膜张肌间隙髂嵴附着处距髂前上棘距离（5.13±0.52）cm(4.25~6.30 cm）,在该间隙内常见臀上神经最下支以及旋股外侧动脉升支臀中肌支穿过,臀上神经最下支穿臀中肌阔筋膜张肌间隙处至股骨大转子外侧最凸点距离为（8.15±0.67）cm(7.13~9.56 cm）;旋股外侧动脉升支臀中肌支走行至该间隙处距离股骨大转子外侧最凸点距离为（5.57±0.39）cm(5.05~6.62 cm）。  结论    髋前外侧肌间隙入路治疗股骨转子间骨折具有安全、暴露充分、软组织损伤小等特点,为股骨转子间骨折的手术治疗提供了新思路和新方法。     

经颅开眶球后入路的应用解剖

目的：给眶内手术入路提供详细的形态学依据和显微解剖参数，分析经颅手术入路的优势及其易损伤结构。方法：用32例(64侧)成人头颅湿性标本，通过模拟额颞眶颧手术入路，在放大5—25倍手术显微镜下，运用显微解剖方法，通过颅前窝眶板开眶，观测开眶后球后结构在不同手术视野下的位置、毗邻、走行、变异、分支、分布等关系。结果：上内侧入路是经上斜肌与上睑提肌之间的问隙入路，暴露从球后到视神经管之让的视神经。上中央入路是经上直肌与上睑提肌之间的间隙入路，根据不同情况向内侧或外侧牵开额神经，暴露视神经眶内段的中部。上外侧入路是通过上直肌与外直肌之让的肌间膜入路，对眶尖深部上外侧区的暴露效果与经眼眶外侧壁的外上方入路基本相同，但前者能兼顾眶上裂与海绵窦，而后者则不能。经外下方入路可暴露肌锥间隙的下外侧区。结论：对于眶内肿瘤应根据病变在眶内的具体位置选择相应的最佳手术入路，有助于克服盲目的破坏性手术。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.